Organization
CHARLES M. RISSLER, OD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES M. RISSLER O.D. (PRESIDENT)
(317) 696-7851
Entity
Organization
Contact information
Practice address
2373 E MAIN ST, PLAINFIELD, IN 46168-2717
(317) 839-0713
Mailing address
1125 BALTUSTROL RUN, AVON, IN 46123-7067
(317) 696-7851
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001745A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200894260B
—
IN
05
—
200894260C
—
IN
01
—
384931
ANTHEM
IN
Enumeration date
05/02/2007
Last updated
06/23/2008
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